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Purpose: This study aimed to identify the relationship between death anxiety, knowledge, and attitudes toward advance directives in middle-aged patients with acute myocardial infarction.Methods: Data were collected through a survey of 142 middle-aged adults from August 27th to October 4th, 2019 in G city. Data analysis was performed using descriptive statistics, t-test, one-way ANOVA, Scheffé test, and Pearson correlation coefficient.Results: The average score of participants’ death anxiety and attitudes toward advance directives was 44.14± 6.71 and 43.61±3.53, respectively, and the average correct rate in knowledge of advance directives was 57.1%. Participants showed significant differences in death anxiety (F=3.75, p=.013), knowledge of advance directives (F=3.02, p=.033), and attitudes toward advance directives (t=2.31, p=.022) depending on the presence or absence of an object to discuss their health status. Also, there were significant differences in knowledge of advance directives (t=3.43, p=.001) and attitude toward advance directives (t=2.23, p=.027) depending on whether participants perceived the meaning of advance directives. There were positive correlations (r=.38, p&lt;.001) between knowledge of advance directives and attitudes toward advance directives in middle-aged patients with acute myocardial infarction.Conclusion: Active information-provision and promotional strategies are needed to enhance a correct understanding of advance directives for middle-aged acute myocardial infarction patients with a high probability of sudden death to recognize the need for an advance directive and reinforce a positive attitude.

The Relationship among Death Anxiety, Knowledge and Attitudes toward Advance Directives in Middle-Aged Patients with Acute Myocardial Infarction